The End of Tanning?

In the wake of research showing strong connections between indoor tanning and melanoma, the sunbed industry is battered and contracting. But the allure of artificially bronzed skin might be dwindling in general.

Ryan Baker, a director of operations for Palm Beach Tan, ushers me through the narrow, pastel hallways of one of the chain's salons in Washington, D.C. It's a tiny place, squeezed into a strip mall between a Chipotle and a beauty parlor. But in a pinch, some see it as a mini-vacation—a dose of artificial sunshine when life’s too busy, or the outside world too cloudy, for the real thing.

Some customers pop in and out of the rooms in 10 minutes, Baker says, while others take their time, luxuriating for a half-hour or more as they primp and apply lotions in the full-length mirrors.

One of the higher-end beds looks like a spaceship, or at least an 80s rendering of one. After the tanner climbs underneath its shiny convex cover, he can blast his preferred music by hooking an iPod up to the built-in speakers. The inside is climate-controlled, and every few minutes it releases a puff of an aromatherapy scent. There are even vertical "beds," for those who prefer not to give up on their standing-desk lifestyles even while soaking up UV rays.

Archer Malmo

Baker repeatedly reminds me that these amenities are to be enjoyed only while hewing to the "golden rules of tanning:”

1) Always know your skin type. Palm Beach uses dermatologists' Fitzpatrick scale, which ranges from "very pale" to "dark brown." People on the paler end of the spectrum should bake for just a few minutes at a time.

2) Take it slow to reach your "cosmetic objectives." Build up a tan by using the beds for short periods over a series of sessions.

3) Apply professional tanning lotions before and after your tan. These don’t protect against UV exposure, but they help with dryness.

4) Always wear eyewear. He tips his head back to demonstrate how one would never sunbathe on a beach with one’s eyes open. Nor should one do this while inside a 63-lamp iBed Swing Commercial Tanning Bed.

"I can't imagine our Creator would be that mean to say, 'Okay I'm going to introduce you to this light, and I'm going to make you crave it and love it, but it's bad for you.'"

He sums it all up with two words: "Tan responsible."

I point to poster of a blond model relaxing on a white-sand beach, her skin like a moist Werther’s caramel. I ask Baker how long he thought it would take for me to look like that.

"Can you tan?" he says, surveying my ghostly pallor. He suggests I think about getting a spray-on instead.

It's this kind of diligence that Baker thinks is why people keep coming to Palm Beach Tan, even as the tanning industry as a whole has shrunk by more than a fifth over the past four years. It’s a period that's been marked by a federal tanning tax, a slew of state-level age restrictions, and an increasingly alarming series of public-health warnings about the dangers of UV exposure.

Even though tanning beds still make up the bulk of the indoor-tanning business, spray tanning is now the only part of the industry that's growing. While big, bronze empires like Palm Beach will probably weather the regulatory storm, hundreds of "mom and pop" tanning places around the country have shuttered.

"It's sad," he says. "Tanning is a fun thing. In our industry, we all know each other, and we just don't want to hear things like that."

Baker looks like a fit soccer dad in his khakis and gingham shirt embroidered with a Palm Beach logo. He's a company man, having worked his way up from a part-time sales associate job in Texas to his current role, in which he oversees 97 stores on the East Coast.

His face is the color of a newborn fawn, a result of what he calls "cocktail tanning"—a combination of sunbed- and spray-tanning. I kept trying to tell myself that he, as well as the gingersnap-hued women behind the counter, would look just as good if they were their natural beige-white.

I asked Baker if he thought people would ever stop tanning entirely.

"No," he said. "Because I'm a beach person. Just going to Virginia Beach or Ocean City, there are people out there trying to get a tan."

And that's the next big challenge for health agencies. Despite how rapidly the warnings and taxes and regulations have beat back the sunbed industry, there’s still something a little glamorous about being tan.

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According to one popular theory, tanning caught on by accident. In the early 20s, Vogue magazine ads were still peddling bleaching creams that claimed to "get rid of tan." Doctors in the early 1900s thought sun exposure caused nervousness and insanity. In his 1905 book The Effects of Tropical Light on White Men, Dr. Chas Edwards Woodruff wrote, “The American girl is a bundle of nerves. She is a victim of too much light."

But in 1929, French fashionista Coco Chanel inadvertently spent too much time in the sun while vacationing in the French Riviera. She shrugged and proclaimed, "A girl simply has to be tanned." That year, there was a sharp uptick in the number of Vogue and Harper's Bazaar articles trumpeting the allure of darker skin. While a Jantzen swimsuit ad from 1927 depicted models sitting under umbrellas and wearing wide-brimmed hats, one from 1929 showed them "frolicking in the sun without sun protection," as one study in the American Journal of Public Health found.

Jantzen swimsuit ads in 1927 (left) and 1929 (AJPH)

In the 1930s, France introduced paid vacations, and both Europeans and Americans increasingly took up outdoor hobbies. Before long a subtle tan became a symbol of youth, leisure, and upward mobility.

In the early 1970s, the German scientist Friedrich Wolff was using ultraviolet lights to analyze the impact of sun exposure on athletes. He noticed an intriguing side effect: The men took on a golden hue. Wolff turned the oddity into a selling point, and the first tanning beds were born.

Appearances are the primary motivator for "laying out:" Surveys have consistently shown that people find tans attractive. One D.C. woman I spoke with was eager to point out that she is by no means a "tanorexic." At the same time, she added, "from a woman's perspective, it's almost the same thing as make-up. [A tan] can help camouflage certain flaws. I have dark circles under my eyes, and it kind of evens out my skin tone a bit.”

When Baker talks about the reasons why people tan, he circles back to what he calls the "look good/feel good,” as though the two states are inseparable.

Other than the look good/feel good, he says customers usually cite "I'm going on vacation, or I'm going to a wedding and I have to wear this dress, or Halloween's coming up and I have a costume that I need to look tan in."

Tanning has become so ingrained, in other words, that "looking tan" is in some ways its own rationale. You need to look tan in that dress. That is the kind of dress one looks tan in.

* * *

Ultraviolet radiation is unique among carcinogens in that it both helps you and, with enough exposure, can kill you. The sun's (or sunbed's) rays spur the production of vitamin D. They also bombard skin cells, mutating DNA and causing wrinkles. Crucially, UV radiation also summons a specific type of immune cell that prompts cancerous growths. Far from protecting against sunburn, a "base tan" is a sign that skin damage has already occurred. According to the CDC, people who tan are more likely to get sunburned.

The skin’s darkening effect is caused by the rapid production of melanin, a type of skin pigment.

“When skin cells develop melanin, it's doing so in response to the damage,” said Len Lichtenfeld, an oncologist and deputy chief medical officer of the American Cancer Society. “It's not doing that because it's a healthy sign.”

The tanning process itself can be addictive: Sunlight stimulates the release of endorphins, resulting in feelings of relaxation or euphoria—the phenomenon sometimes called "runner's high."

"Tanning makes you feel good. But so does methamphetamine," said Joel Hillhouse, a professor of public health at East Tennessee State University who has studied the psychology of tanning. He said some of his study subjects have stolen money or broken into tanning salons to get their fix.

Using tanning beds increases the risk of developing melanoma, the most deadly form of skin cancer, by 59 percent. More than 60,000 new melanomas are diagnosed in the U.S. annually, but treatment of other types of skin cancers increased by nearly 77 percent between 1992 and 2006. Skin cancer is now the most common type of cancer in the U.S.

Melanoma Incidence Rates by Gender

Data from the National Cancer Institute, projected after 2010 (Surgeon General's office)

Public health authorities have responded swiftly and, tanning salon owners say, severely. In 2009, the International Agency for Research on Cancer classified tanning beds as a Group 1 carcinogen, in the same category as cigarette smoke and asbestos. The 2010 Affordable Care Act included a 10 percent tax on indoor tanning services.

Earlier this month the surgeon general released a report calling attention to the dangers of tanning, saying in an introductory letter that "tanned skin is damaged skin." It was the first time a surgeon general had focused on skin cancer specifically.

The FDA also recently reclassified the safety level of tanning beds from low-risk—on par with Band-Aids—to moderate-risk, like condoms and wheelchairs. On top of that, the agency mandated that the beds carry a black-box warning stating that they should not be used by minors.

Age Restrictions on Indoor Tanning

Data from the National Conference of State Legislatures (Surgeon General's office)

Because sunburns during childhood cause a particularly sharp increase in the likelihood of developing skin cancer, in recent years nine states have barred anyone under the age of 18 from using tanning beds. Thirty-two others regulate the devices’ use by minors.

* * *

The laws and warnings have prompted widespread outrage among tanning enthusiasts. Today, the conversation on the science behind skin cancer can be as vicious as the one about climate change.

"We're agrarian by nature," said Rob Quinn, CEO of a chain of 40-some Tan Pro stores in Ohio, referring to humanity. "We crave nourishment, water, and sunlight. I can't imagine our Creator would be that mean to say, 'Okay I'm going to introduce you to this light, and I'm going to make you crave it and love it, but it's bad for you.'"

Quinn believes that the recent anti-tanning push is a conspiracy by the world's dermatologists, and that we will yet see the lasting negative repercussions of keeping a generation of humans out of the sun. He said that Ohio has lost 40 percent of its registered tanning salons, and that the customer headcount in some stores is down by nearly half.

Baker is hyper-aware, and hyper-sensitive, to accusations that people who use sunbeds have a higher risk of developing skin cancer.

"I've read enough to know that it's very difficult to say that one thing or another is causing this or that," he said. "I don't agree [that there's a strong link between indoor tanning and melanoma]. There's a lot of factors that go into that type of serious disease."

"The kid wants to get a suntan, and the government won't let them."

When I asked what conclusions he's drawn from his readings, he declined to comment.

Though minors make up just two or three percent of most tanning salons' customers, the recent under-18 bans have been the source of particular scorn within the tanning industry.

"Whether or not a 17-year-old or 16-year-old gets a suntan, that should be up to his or her parents, not the government," John Overstreet, the executive director of the Indoor Tanning Association, told me. "The kid wants to get a suntan, and the government won't let them."

He points out that there are already warnings against overexposure on most tanning salon intake forms and on the beds themselves. "With all these warnings, why do people do this?" he said. "I honestly believe it's because we're being given bad advice."

* * *

After decades of soaking up the sun, there are signs that we might be returning to the age of the parasol—or at least a bottle of SPF 30 in every beach tote.

"There's been a cultural shift," Hillhouse, the psychologist, said. "Fifteen years ago, you would not have seen an article in Seventeen or Cosmopolitan about the dangers of indoor tanning, but now it's very common."

Quinn said that the drumbeat of skin-cancer coverage has spooked even the most devoted tanners, who now say things like, "I know it's bad for me, but I just love doing it."

Some have switched to spray tanning, even though it doesn’t generate the same “feel good” boost, he says.

But there are other signs that tanning, as a principle, is becoming passé.

"A coppertone complexion isn't looking so fresh this summer season," proclaimed a style article in USA Today last year, pointing to the rise of pasty beauties like Emma Stone and Taylor Swift.

"We're not seeing [people] flocking to tanning," Karen Grant, a beauty analyst with NPD, told me. A decade ago, fake-tan lotions made up 65 percent of sales in the "sun category," she said, but today, sunscreens dominate that market. "There's a higher awareness of safety, or lack thereof. The movement has been toward protection."

Slightly less than a third of non-Hispanic white women, who make up the majority of indoor-tanning customers, still use tanning beds. However, data from the CDC show that the number of high-school students who used indoor tanning devices has declined by about three percentage points (from 16 to 13 percent) since 2009, though that number is within the margin of error. Among girls, the drop-off was six percentage points.

Lichtenfeld noticed that when he was recently vacationing on a beach in south Georgia, roughly three out of four families were huddling under a canopy or umbrella.

It was anecdotal, to be sure, but nevertheless, “it was a lot different than what I have seen before, so maybe we are making some progress after all,” he wrote on his blog at Cancer.org.

Tanning-related posts to the "Girls Survival Guide" section of Reddit are now dominated by questions of how to achieve "a glow" without a tanning bed. A recent video showing the protective effects of sunscreen—posted by Upworthy under the headline "What Happens To Your Face When You Wear Sunscreen Might Shock You"—has generated more than 30,000 Facebook likes. The comments are tinged with exuberant outrage: "Sunscreen is a must. I want to live!!!!!!!!!!!"

* * *

There are limits to health-scare mongering, though. A February study that surveyed sorority members found that 45 percent used tanning beds even though most knew about the cancer risk.

Hillhouse says that the most effective anti-tanning campaigns focus instead on how the practice can disfigure skin over time. Rather than ads that, say, portray sunbathers as laying in their own coffins, he recommends posters like one recently commissioned by Britain’s NHS, which shows a young blond woman with a mottled face and a nasty melanoma on her lip.

There haven't been any national American campaigns like this yet. But a "your skin on sun"-type strategy might make tanning go the way of smoking—another cancer-causing pastime that has declined precipitously in recent decades. Research has shown that appearance-based ads are the most effective kind for urging younger users to quit smoking.

Hillhouse also said he's seen success with pointing younger women toward websites that promote clothing and jewelry styles that go with fair skin, since many believe tanning is essential to their overall "look."

"We provided access to information on how you develop a different look that's focused around a more natural skin color," he said. "Then they'll start to change their behavior."